Department of Pediatrics, Turku University Central Hospital, Turku, Finland.
Clin Exp Allergy. 2011 Mar;41(3):370-7. doi: 10.1111/j.1365-2222.2010.03657.x. Epub 2010 Dec 1.
The intestinal mucosa functions as a defence barrier against gut intraluminar antigens. The maturational events in the gut parallel its step-wise colonization. Atopic dermatitis (AD) is associated with aberrant barrier functions of the skin epithelium and, in a subgroup of patients, of the gut mucosa.
To investigate the interaction of Lactobacillus rhamnosus GG (LGG) with skin and gut microbiota and humoral immunity in infants with AD.
Thirty-nine infants with AD were randomized for a 3-month period in a double-blind design to receive extensively hydrolysed casein formula supplemented with (n=19) or without (n=20) LGG (ATCC 53103) 5.0 × 10⁷ CFU/g to achieve a daily intake of 3.4 × 10⁹ CFU. Sampling (blood and fecal samples, cotton swab from the skin) was carried out at entry, 1 and 3 months thereafter. Ig-secreting cells were determined by enzyme-linked immunospot and the proportions of CD19(+)CD27(+) B cells among peripheral blood leucocytes by flow cytometry. The major groups of gut and skin bacteria were characterized using PCR.
The proportions of IgA- and IgM-secreting cells decreased significantly in the treated group; the baseline-adjusted ratios for treated vs. untreated at 1 month were 0.59 (95%CI 0.36-0.99, P=0.044) for IgA- and 0.53 (95%CI 0.29-0.96, P=0.036) for IgM-secreting cells. The proportions of CD19(+)CD27(+) B cells increased in the probiotic-treated infants but not in the untreated. There were no significant differences in bifidobacterial species composition of the gut between the study groups. On the skin, the bacterial counts of Bifidobacterium genus vs. Clostridium coccoides in the treated and untreated infants were similar.
Specific probiotics may enhance gut barrier function and aid in the development of immune responses. Thus, specific probiotics may afford protection against offending macromolecules in the gut and provide control for future infections by accelerated immunological maturation (ClinicalTrials.gov ID NCT01148667).
肠道黏膜作为肠道内抗原的防御屏障。肠道的成熟事件与它的逐步定植过程平行。特应性皮炎（AD）与皮肤上皮和肠道黏膜的异常屏障功能有关，在一部分患者中，与肠道黏膜有关。
研究鼠李糖乳杆菌 GG（LGG）与皮肤和肠道微生物群和体液免疫在 AD 婴儿中的相互作用。
39 例 AD 婴儿以双盲设计随机分为 3 个月的研究期，接受深度水解酪蛋白配方，补充（n=19）或不补充（n=20）LGG（ATCC 53103）5.0×10⁷CFU/g，以达到每日摄入 3.4×10⁹CFU。在入组时、1 个月和 3 个月后进行采样（血液和粪便样本、皮肤拭子）。通过酶联免疫斑点法测定 Ig 分泌细胞，通过流式细胞术测定外周血白细胞中 CD19(+)CD27(+)B 细胞的比例。采用 PCR 方法对肠道和皮肤主要菌群进行特征描述。
治疗组 IgA 和 IgM 分泌细胞的比例显著下降；与未治疗组相比，治疗组 1 个月时的基线调整比值分别为 0.59（95%CI 0.36-0.99，P=0.044）和 0.53（95%CI 0.29-0.96，P=0.036）。治疗组婴儿的 CD19(+)CD27(+)B 细胞比例增加，但未治疗组婴儿无此变化。两组肠道双歧杆菌物种组成无显著差异。在皮肤部位，治疗组和未治疗组婴儿双歧杆菌属与梭状芽胞杆菌属的细菌计数相似。
特定的益生菌可能增强肠道屏障功能，并有助于免疫反应的发展。因此，特定的益生菌可能提供对肠道内致病大分子的保护，并通过加速免疫成熟提供对未来感染的控制（ClinicalTrials.gov ID NCT01148667）。
